Part 1 - Personal Particulars
*Name:
Dr
Mr
Mrs
Ms
Mdm
NRIC/ Citizenship No.:
Nationality:
Home Telephone:
Mobile:
*Email:
Gender:
Male
Female
Marital Status:
Age:
Race:
Part 2 - Language Proficiency
Spoken:
Written:
Part 3 - Tell Us More
How do you hope to make a difference as an IMH volunteer?
Part 4 - Volunteer Interests
Gardening
Music Therapy
Singing & Dancing
Art Therapy
Patient Outings
Wall Murals
Games & Sports
Befriending
Festive Celebrations
Event Support
Host IMH Tours/ Meet & Greet
Fund-raising
Pet Therapy
Others (pls specify)
Part 5 - Availability
Ad-hoc/ Project Basis
Permanent Basis
Yearly
Half-yearly
Quarterly
Monthly
Fortnightly
Weekly
Part 6 - Understanding
I understand that IMH reserves the right to accept or decline my voluntary services depending on the match between my interests and the current needs of IMH. If my services are rendered, I will abide by the terms and conditions of IMH. I will keep information given by staff and/ or volunteers confidential.
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